Discussions By Condition: General well-being

Coma

Posted In: General well-being 0 Replies
  • Posted By: Anonymous
  • August 11, 2006
  • 09:42 PM

I am really lucky to find such this service that you offer for people to get answers of their medical inquires and I hope to get reply to my message. I got complete medical report and I hope this will give you clear picture of the case to have consultation or your advice to help my father.
Age/sex: 72 years/ Male
Diagnosis: Fecal peritonitis on top of colonic perforation, cancer colon, post operative renal failure
Medical history
Patient bedridden since 5 years due to severe Osteoarthritis under treatment

Five days before admission patient complaint vomiting, constipation, progressive abdominal distension with no abdominal pain

On examination patient was drowsy, dyspneic, afebrile, Bp 140/90, and PO2 80% on room air. Abdomen was highly distended, hyperresonant, intestinal sounds are audible otherwise soft, lax with no palpable masses and hernial orifices were free. PR: empty rectum

Laboratory results show, no leucocytosis, raised hematocrit levels, liver and renal parameters within normal levels. X-ray abdomen shows hugely distended colon. Enema with gastrograffin shows no obstructive lesion and no intra peritoneal spillage of the dye

Acute colonic psodo obstruction (ogilvie's syndrome) was retained. As primarily diagnosis in critically ill patient.

Patient admitted to ICU and intubated, mechanically ventilated

Urgent colonic decompression was decided and done with collaboration with gastroenterologist revealing colonic tumor of the left side, liver and renal parameters start to be disturbed

The patient condition was reviewed by a multidisciplinary team after gastroenterologist findings as the patient carry a high risk of surgical and anesthetic problems. The patient family was informed as about actual condition and that surgical procedure was the only hope

Patient operated 2 months ago , exploartion revealed Caecal perforation, peritonitis and Hartman procedure done

On the post operative period patient was stll critically ill, mechanical ventilation maintained, as the O2 saturation drops. Hemodynamically patient unstable, and vasopressor drugs were instituted

Renal parameters were disturbed (urea, creatinine, K ) and progressively increase and patient started to be hemodialyzed 1 month postoperativelly

At the operative site, the colostomy was functioning and evidence of wound infection present in the 7th day post operative and regularly dressed and progressively ameliorating

The post operative anemia, disturbed, coagulation parameters were effectivelly controlled with transfusion

As the patient was unconscious, mechanically ventilated for a long period decision to do tracheostomy was done 1 month post operative

Actually patient is unconscious, mechincally ventilated and on regular hemodialysis and laboratory results (blood picture, liver functions, renal functions) controlled
This is a complete medical report for the case
Please all doctors who can make these points clear for me and gives me advice and what predicts of such this case to send me
I thank all people who can help my father with any opinion

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